Bilateral Electrical Stimulation of Prelemniscal Radiations in the Treatment of Advanced Parkinson's Disease

Abstract

Raprl electrical stimulation is safe and efficient to treat patients with the Parkinson's disease symptomatic triad. By use of Raprl stereotactic coordinates, electrodes were placed behind the subthalamic nucleus.

Swallowing function in Parkinson's patients following Zona Incerta deep brain stimulation

“…for PD but also the posterior subthalamic area (PSA) including the caudal Zona Incerta (cZI), has been suggested as an alternative target in PD (8)(9)(10)(11)(12). Improvements in global motor function and in health-related quality of life are seen in STN DBS (13)(14)(15)(16)(17).…”

Control of phonatory onset and offset in Parkinson patients following deep brain stimulation of the subthalamic nucleus and caudal zona incerta

“…Regarding DBS in the cZi and adjacent areas, promising results have been presented for motor effects [11][12][13][14][15][16] and it has been suggested as a possibly more effective target than the STN on axial symptoms of PD [17]. The effects of cZi-DBS on speech are, however, largely unknown, with the exception of two previous reports from our group, indicating it to be less beneficial to intensity and articulation rate and precision in articulatory coordination than STN- The present investigation aimed at investigating the laryngeal motor proficiency needed for regulating phonation in fluent speech in patients treated with either STN-DBS or cZi-DBS.…”

Emerging Targets for Stimulation-Refractory Movement Disorders

“…No intraoperative complications were reported. Finally, Carrillo-Ruiz et al [69] have extended the prior work of both groups through examination of bilateral PRL targeting for treatment of tremor predominant PD in (n=5) patients. Using bipolar stimulation, nine of ten electrode arrays had at least one contact in the PRL while four of ten had both active contacts within the PRL.…”

“…Only partial effect was observed in chronic stimulation for this patient. Otherwise, mild and transient limb ataxia [70], dysarthria [67,69], hemispastic gait [68], and diplopia or blurred vision were reported [67,68]. Sensory side effects included hand paresethesias that disappeared within seconds of activation [68,70].…”

“…Sensory side effects included hand paresethesias that disappeared within seconds of activation [68,70]. Neuroaffective worsening included exacerbation of preexisting depression that required an increase in medication and a decrease in voltage [67,69]. Table 2 summarizes the targeting locations and methods used by each of the different groups.…”